From the Departments of *Psychiatry and †Anesthesiology, Mount Sinai School of Medicine, New York, NY.
J ECT. 2013 Dec;29(4):e63-5. doi: 10.1097/YCT.0b013e3182972b8c.
We report the case of a 27-year-old man with mild-moderate intellectual disability (ID) and bipolar disorder treated with electroconvulsive therapy (ECT). He was psychiatrically hospitalized for agitation, aggression, and manic symptoms including insomnia, rapid and pressured speech, and hyperactivity. After multiple medication trials, ECT was recommended. The treatment was delayed owing to the need to obtain evaluation for incapacity and then substituted consent from the patient's mother. He received 2 ECT treatments with marked improvement but complicated by transient fevers, which resolved without treatment. Fever workup was unremarkable. The patient became calm and cooperative and was discharged home. He was readmitted 3 weeks later, again in an agitated manic state. He received 5 additional ECT treatments, but this time with no post-ECT fevers. Once again, his manic symptoms resolved, and he was safely discharged. Whereas patients with ID pose special challenges, our case is in keeping with the previous literature, which supports the use of ECT in patients with ID and comorbid psychiatric disorders.
我们报告了一例 27 岁男性，患有轻度至中度智力障碍（ID）和双相情感障碍，接受了电休克治疗（ECT）。他因躁动、攻击和躁狂症状（包括失眠、快速和紧张的言语以及多动）而被精神科住院治疗。在多次药物试验后，建议进行 ECT。由于需要获得无行为能力评估，然后从患者的母亲处获得替代同意，治疗被推迟了。他接受了 2 次 ECT 治疗，症状明显改善，但伴有短暂发热，未经治疗即可缓解。发热检查无异常。患者变得冷静和合作，出院回家。3 周后，他再次因激动性躁狂状态入院。他又接受了 5 次 ECT 治疗，但这次治疗后没有发热。他的躁狂症状再次得到缓解，并且安全出院。尽管 ID 患者带来了特殊的挑战，但我们的病例与之前的文献一致，支持在 ID 合并精神障碍的患者中使用 ECT。
